Can CBD Ease Neuropathic Pain?
Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.
- What causes neuropathic pain, and what can we do to avoid this?
- What are the main symptoms of neuropathic pain?
- How can neuropathic pain be managed?
- What is diabetic neuropathy?
- How effective is CBD in the treatment of neuropathic pain?
- The bottom line
- Frequently asked questions (FAQs)
Neuropathic pain is usually caused by progressive nerve disease and can also occur as a result of infection or injury. This condition is characterised by hyperalgesia (abnormal hypersensitivity to stimuli) and allodynia (nociceptive responses to non-noxious stimuli).
Different pathophysiological states and conditions - such as viral infections, metabolic disorders, and autoimmune diseases affecting our central nervous system (CNS) - can also cause neuropathic pain. As showcased by statistics, the prevalence of neuropathic pain in the general population is estimated to be between 3% to 17%. Additionally, this condition is more prevalent among women (60.5%) and reaches its peak at 50 to 64 years of age.
Besides that, neuropathic pain is associated with chronic conditions and can flare up at any time, even without a pain-inducing factor. An acute type of neuropathic pain can also occur, although it is uncommon. Studies suggest that one in three American experiences chronic pain, while one in five Americans experience neuropathic pain.
Typical, non-neuropathic pain usually occurs due to an illness or injury. For example, if we hit our little toe on the sofa, our nervous system immediately sends signals of pain to our brain. The main difference with neuropathic pain is that it isn’t triggered by an injury or event. Instead, our body sends pain signals to the brain without any reason. The perceived pain is spontaneous, manifesting itself without needing any stimulus. People suffering from this condition may experience shooting, burning pain, which tends to get worse over time. A loss of sensation, as well as a feeling of numbness, is also common in the case of neuropathic pain.In general, neuropathic pain affects the patient’s quality of life greatly, compromising their psychological condition. Most of the currently available treatments for this pathological condition have low to moderate efficiency as well as side effects that may limit their use. Henceforth, more effective and safer therapeutic approaches are needed for individuals suffering from neuropathic pain that are able to reduce the symptoms of the disease and improve quality of life in general.
What causes neuropathic pain, and what can we do to avoid this?
The most common causes of this chronic condition can be divided into four groups:
- Loss of a limb
Infections rarely cause this type of pain, though there are several conditions that may trigger temporary or consistent neuropathic pain.
Shingles, which is caused by reactivation of the chickenpox virus, can trigger several weeks or, in some cases, several months of neuropathic pain along a nerve. Besides that, postherpetic neuralgia, a rare complication of shingles, can cause persistent neuropathic pain as well. People with HIV or syphilis may also experience burning or stinging pain.
Besides infections, neuropathic pain can also be a symptom of several diseases and conditions, such as certain types of cancer, multiple sclerosis, and diabetes. Neuropathic pain doesn’t always occur in people with these disorders, although it can be an issue for some individuals.
According to Cleveland Clinic, diabetes comprises up to 30% of all neuropathic cases as this condition can impact how our nerves work. People suffering from diabetes often experience numbness and loss of feeling that is followed by pain, stinging and burning in their limbs.
Long-term alcoholism can damage nerves too, which can also lead to a range of complications, including, neuropathic pain and have long-lasting and painful effects. Trigeminal neuralgia belongs to the more common types of neuropathic pain and can occur without any reason manifesting itself as severe pain on one side of the face.
Autoimmune disorders affecting the CNS, such as multiple sclerosis and Guillain-Barre syndrome, may also become a reason for the development of this type of pain. In addition to this, cancer treatment may induce neuropathic pain. Chemotherapy-induced peripheral neuropathies, as well as radiation therapy, can impact the nervous system and cause pain signals.
Different injuries to bones, muscles or soft tissues can also cause neuropathic pain, though they are uncommon. Problems with back, joints, and legs or any other injuries can cause long-lasting nerve damage, which may result in neuropathic pain.
The most unpleasant factor in pain caused by various injuries is that the damage to the nervous system may not disappear even if the injury is healed. As a result, people may experience persistent neuropathic pain for many years after the accident. Spine injuries, such as spinal cord compression or herniated discs, can damage the nerve fibres along the spine, causing neuropathic pain too.
Amputation of limbs may also be a reason for neuropathic pain occurrence, leading to so-called phantom limb syndrome. Despite the limb loss, the brain still thinks it is receiving pain signals from the amputated body part. So, what is the physiology behind this process?
In the case of phantom limb syndrome, the nerves near the amputation site are misfiring and sending faulty pain signals to the brain, thereby causing a feeling of pain in the area of the removed body part. Phantom pain may occur in legs, arms, toes, fingers, ears, and other parts of the body.
Other causes of neuropathic pain can include:
- Nerve compression or infiltration by tumours
- Parkinson’s disease
- Metabolic disorders (such as peripheral diabetic neuropathy)
- Hereditary neuropathies
- Carpal tunnel syndrome
- Arthritis in the spine
- Vitamin B deficiency
- Thyroid problems
What are the main symptoms of neuropathic pain?
Some of the symptoms of this condition may vary from one patient to another, although most signs of the disease are common. They include:
- Spontaneous shooting, burning, or even electric shock-like pain that comes without any stimulation.
- Numbness and tingling or pins and needles.
- Evoked pain that is caused by events that are typically not painful. This condition is called allodynia and can occur with the application of normally non-painful stimuli, such as pressure, cold, brushing the hair or rubbing against something. Besides this, evoked pain may also cause an increase in pain by normally painful stimuli, such as heat or pinpricks. This condition is known as hyperalgesia. As well as hyperalgesia, people with neuropathic pain may al
- so feel hypoalgesia - pain that is lessened in response to a normally painful stimulus.
- Having trouble sleeping and resting.
- Emotional problems, which are usually a result of pain and disturbed sleep.
How is neuropathic pain diagnosed?
A healthcare professional can determine whether or not a patient has neuropathy by asking about their symptoms and medical history. A physical examination is always performed to check the level of sensitivity to touch and temperature, muscle tone, blood pressure, and heart rate. In some cases, a physician may also perform a filament test to check the sensitivity in the patient’s feet. For this procedure, nylon fibre is used to check the limbs for any loss of sensation. In addition to this, a tuning fork may also be used to check the patient’s vibration threshold. Neuropathic pain is characterised by its typical symptoms when the damage of nerve fibres is known or suspected. In many cases, doctors try to find the primary cause for this condition and then track the neuropathic pain symptoms.
The next stage after a definitive diagnosis has been made is to select the most appropriate and effective treatment for each particular case. The primary goal of all existing treatment methods for neuropathy is to identify the root of the problem - an underlying disease or condition - which is responsible for the pain, and treat it, if possible. For example, where a tumour is pressing on the nerve, radiation therapy or surgery may be needed to shrink it and reduce the pressure.
Each of the neuropathic pain treatments aims to provide maximum pain relief for the patient, thereby helping them to perform usual tasks despite the pain and improve their quality of life. Generally, we can highlight four main goals of neuropathic pain treatment:
- Treat the underlying disease or condition
- Alleviate pain
- Maintain functionality
- Improve quality of life
How can neuropathic pain be managed?
To date, the most commonly prescribed treatments for neuropathic pain include:
- Over-the-counter (OTC) pain medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Motrin and Aleve, can be used to treat neuropathic pain. Although these medications provide the patient with pain relief by relieving the symptoms, they aren’t effective enough as they don’t target the source of the pain.
- Prescription medication
Despite the fact that opioids are currently the most potent painkillers, they can’t usually reduce neuropathic pain as effectively as they can manage other types of pain. Moreover, most doctors try not to prescribe them for long periods of time, since these drugs may cause opioid addiction, which, in turn, may lead to severe complications and even death. Opioid analgesics may provide some relief, although the negative effects from its use often outweigh the benefits. Topical patches (such as Capsaicin or Lidocaine), as well as different creams or ointments, can also be used on the painful area.
Antidepressant medications have shown great promise in treating neuropathic pain symptoms. Preparations, such as Cymbalta, Pamelor, Elavil, and Effexor are often prescribed by doctors to treat both neuropathic pain and symptoms like anxiety or depression. There are two common types of antidepressant medications commonly prescribed to people with a neuropathic pain diagnosis. They include tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors.
Anti-seizure medications and anticonvulsants are often used for neuropathic pain treatment. The most commonly prescribed anti-seizure drugs include Lyrica, Neurontin, Tegretol, Lamictal, and Topamax. It is still not clear why anti-seizure drugs are effective for this condition as a doctor’s prescription for these medications doesn’t mean the patient has seizures. However, researchers believe that this type of drug interferes with pain signals and can stop faulty transmissions in the case of neuropathic pain.
- Nerve blocks
Nerve blocks are usually given by pain specialists. This method of neuropathic pain treatment includes injection of local anaesthetics, steroids, or other medications into the affected nerves that are thought to be responsible for the pain signals. The effect of these nerve blocks is temporary, so they must be repeated in order to continue to relieve pain.
- Implantable devices
A surgeon implants a device in the brain or spine, depending on the affected place. The device sends electric impulses causing stimulation of the spinal cord, brain or nerve roots. These impulses can control neuropathic pain symptoms and stop irregular nerve signals. As this procedure is invasive and requires surgical intervention, it is usually only used in individuals who haven’t responded well to other treatment methods.
- Lifestyle treatments
In many cases of neuropathic pain, multimodal therapy, which includes medicines, surgery, physical and psychological therapy, is required. Physical, massage and relaxation therapies can help ease muscles and are often used alongside other treatment options. An occupational therapist or a physical therapist teaches people suffering from neuropathic pain techniques to prevent pain, such as stretching, sitting, moving, and standing. The consultation of these specialists is necessary as neuropathic pain may increase, for example, after sitting for several hours. By teaching possible ways to cope with the pain, people can manage their symptoms and perform everyday tasks without the risk of aggravating the symptoms.
Can we prevent neuropathic pain from ever occurring?
If the underlying cause for this condition has been identified, proper treatment may help to significantly reduce the pain or even eliminate it. For example, one of the most common causes of neuropathic pain is diabetes. By leading a healthy lifestyle, which includes a healthy diet and regular exercise, we may eliminate neuropathic pain or reduce the risk of its appearance.
Neuropathic pain usually has a highly negative impact on our life and may worsen if we don't take steps to treat it. Over time, this condition can lead to serious complications and disabilities, including anxiety, depression, sleeping problems, and others. Nevertheless, when detected early, multimodal therapy can be an effective way to manage this condition. A combination of different treatment options, including medications, physical therapy, surgery, and psychological treatment, may be used to bring the most beneficial results.
Peripheral and diabetic neuropathy - what is the difference?
Peripheral neuropathy is a result of damage to the peripheral nerves. This condition causes pain, numbness, and weakness in hands and feet and can develop suddenly or spread slowly over time. Peripheral neuropathy can be caused by:
- Diabetes mellitus
- Traumatic injury
Our peripheral nerves are like billions of transmitters and send messages from the brain and spinal cord to the rest of our body, allowing us to walk, do sports, and perform everyday tasks, most of which we do on autopilot. The main job of all these nerves is to deliver signals about physical sensations back to the brain. The peripheral system of our body includes:
- Internal organs
The situation changes dramatically when those nerves are damaged. In such cases, all the signals from our peripheral nervous system are interrupted, which affects how our body responds to pain, reflexes, and temperature.
There are more than a hundred types of peripheral neuropathy, each of which has unique symptoms and treatment options. This disorder is uncomfortable and debilitating, although existing treatments can be very helpful. The most important thing prior to starting treatment is to determine whether peripheral neuropathy is the result of a serious underlying condition.
There are three types of peripheral nerves in our body:
- Sensory nerves, which connect to our skin
- Motor nerves, which connect to our muscles
- Autonomic nerves, which connect to our internal organs
Peripheral neuropathy can affect one of these nerve groups or all three. The main symptoms of this condition are:
- Sharp, stabbing pain or cramping
- Numbness in the hands or feet
- Tingling in the hands or feet
- Thinning of the skin
- A drop in blood pressure
- Digestive difficulty
- Sexual dysfunction
- Heavy feeling in the arms and legs
- A buzzing or shocking sensation
- Excessive sweating
According to data provided by the University of Chicago’s Center for Peripheral Neuropathy (UCCPN), about 60% of people diagnosed with diabetes have some sort of nerve damage, including peripheral neuropathy. However, besides diabetes, other chronic diseases may cause nerve damage as well:
- Kidney disorder
In this condition, a high amount of toxins build up in the body and damage nerve tissue.
- Deficiency of vitamins E, B-1, B-6, and B-12
These vitamins are essential to proper nerve functioning.
This condition occurs when the body doesn’t produce enough thyroid hormone. It may lead to fluid retention and pressure surrounding nerve tissues.
- Diseases that cause chronic inflammation
These diseases can damage connective tissues surrounding nerves or spread to the nerves.
How is peripheral neuropathy diagnosed?
The first step for a doctor in diagnosing peripheral neuropathy is to perform a physical examination and to ask the patient about their medical history. Where the existing symptoms don’t exclude other diseases, a healthcare professional may ask to perform additional tests in order to make a definitive diagnosis. Among the most commonly ordered tests are:
- Imaging tests
CT or MRI scans allow a doctor to check if anything is pressing on a nerve, such as a tumour or herniated disc.
- Blood tests
These tests are usually ordered to check the correct functioning of the patient’s thyroid. These tests can also provide information about vitamins and blood sugar levels.
- Nerve biopsy
This minor surgical procedure involves removing a small part of nerve tissue to examine it under a microscope.
This test can show possible problems with how nerve signals move to the muscles. To perform this procedure, a doctor places a small needle into the muscle and asks the patient to move a muscle gently.
- Nerve conduction study
A doctor places electrodes onto the patient’s skin and a tiny amount of electricity is passed through the nerves to check if the nerve roots can transmit signals properly.
How is peripheral neuropathy treated?
All the current peripheral neuropathy treatment options have one goal in common - to treat the underlying disorder. For example, if diabetes is the cause of the disease, regulation of the blood sugar levels is important. If the roots of peripheral neuropathy lie in vitamin deficiency, correcting this deficiency and revising nutrition is the line of treatment. Many of these treatment methods can bring relief and help people to return to their regular activities. In some cases of peripheral neuropathy, a combination of different treatment options may work best.
Most commonly, OTC pain medications are the first prescribed option to alleviate peripheral neuropathy symptoms. Drugs like acetaminophen (Tylenol), along with NSAIDs, such as ibuprofen and aspirin, can be very effective in controlling low to moderate pain, although it is important not to use them for an extended period as they can affect stomach and liver function. If the pain is severe and OTC and NSAIDs medications aren’t effective enough, prescription pain medications might be prescribed. These drugs may include antidepressants, narcotics, and antiepileptic medicines. Prescription medications also include:
- Cyclooxygenase-2 inhibitors
- Corticosteroid injections
- Seizure medications, such as pregabalin or gabapentin
- Serotonin-norepinephrine reuptake inhibitors, such as Cymbalta
Besides OTC pain relievers and prescribed medications, many people with peripheral neuropathy have found relief for their symptoms through:
- Chiropractic care
Symptoms of peripheral neuropathy can be successfully managed if the underlying condition has been identified and treated. A healthcare professional can help patients to choose the most effective medical treatment or alternative options that would supplement the medical care, depending on each particular case.
What is diabetic neuropathy?
Diabetic neuropathy is a serious complication of type 1 and type 2 diabetes. This condition is a type of nerve damage caused by long-term high blood sugar levels. Diabetic neuropathy affects nearly 50% of all individuals diagnosed with diabetes during their lifetime. Usually, this condition develops slowly and requires constant monitoring and treatment. In cases of prolonged neuropathy, patients may be vulnerable to infections and injuries, while in serious cases, it may even lead to amputation.
The symptoms of this condition usually appear gradually. In many cases, the early types of nerve damage appear in the nerves of the feet, causing pins and needles. Symptoms of diabetic neuropathy usually vary depending on the area that is affected.
Common signs for different types of diabetic neuropathy include:
- Pain in the hands or feet
- Loss of sensation
- Muscle weakness
- Numbness in hands or feet
- Burning sensation in feet
- Bladder problems
- Nausea or vomiting
- Increased heart rate
- Excessive sweating
- Vision trouble
- Erectile dysfunction
There are different types of diabetic neuropathy, and each of them affects different areas of the body and has unique symptoms. In individuals with diabetes, there are four main types of nerve damage:
- Peripheral neuropathy
This type of neuropathy is the most common one, whereby the main symptoms of this condition as well as the possible methods of its treatment have been reviewed above.
- Autonomic neuropathy
This is the second most common type of neuropathy in people with diabetes. Our autonomic nervous system is responsible for a range of processes and systems in our body over which we don’t have conscious control. Muscles and organs that are under the control of the autonomic nervous system include the digestive and cardiovascular system, the bladder, sex organs and sweat glands.
Autonomic neuropathy may cause:
- Nerve damage to the digestive system (diarrhoea, constipation, gastroparesis, swallowing trouble)
- Bladder problems (urinary incontinence, difficulty fully emptying the bladder)
- Cardiovascular problems (drops in blood pressure, dizziness, lightheadedness, abnormally fast heart rate)
- Proximal neuropathy
This form of neuropathy is also known as diabetic amyotrophy and is quite rare. Proximal neuropathy most often occurs in adults over fifty years old and is more common in men. This type of neuropathy affects the thighs, hips, and buttocks, and in some cases, may cause sudden and severe pain. In addition to this, proximal neuropathy usually affects only one side of the body. With a diabetic amyotrophy diagnosis, many people recover within a few years, even without treatment.
- Focal neuropathy
Focal neuropathy or mononeuropathy appears when there is damage to a group of nerves or to one specific nerve, which causes weakness in the affected area. Most often, focal neuropathy occurs in the head, leg, torso, or hand. This condition is often very painful and may appear suddenly. Similarly to diabetic amyotrophy, most symptoms of mononeuropathy may go away in a few weeks or months without treatment. The most common symptoms of focal neuropathy include:
- Pain in isolated areas, such as the chest, pelvis, lower back, stomach, outside the lower leg, and inside the foot
- Numbness and tingling
- Double vision
- Bell’s palsy
- Pain behind the eyes
Carpal tunnel syndrome is the most prevalent type of mononeuropathy, symptoms of which usually go unnoticed. However, about 25% of people with diabetes state they have felt nerve compression at the wrist.
What is the primary cause of diabetic neuropathy?
Most often, this condition is caused by high blood sugar levels that last for a long period of time. However, besides high blood sugar, there are also some other factors that can lead to this nerve damage, such as:
- Excessive alcohol use
- High cholesterol levels that may damage the blood vessels
- Low levels of vitamin B12
- Mechanical injury (for example, carpal tunnel syndrome)
How is diabetic neuropathy diagnosed?
Diabetic neuropathy is diagnosed in a similar way as peripheral neuropathy. A healthcare professional can determine whether the patient has this condition by asking about their symptoms and medical history. The consultant will also check the level of sensitivity to touch and temperature, muscle tone, blood pressure, and heart rate. The doctor may also do a filament test with a nylon fibre to test the sensitivity in the patient’s feet, and a tuning fork to check vibration threshold.
How is diabetic neuropathy treated?
To date, there is no cure for diabetic neuropathy, but people with this diagnosis can slow its progression and manage the symptoms. Keeping the blood glucose levels within a normal range can help to significantly decrease the risk of developing diabetic neuropathy, as well as slow its progression and relieve some of the symptoms. Managing life factors, for example, exercising regularly and quitting smoking can also be a part of a comprehensive treatment plan that can alleviate the disease symptoms and improve the quality of life in general. As pain is the hallmark of this condition, medications are also used for pain management. Several medications, such as capsaicin, have been shown to help with the symptoms of this disease, although it is recommended to talk to the doctor about prescribed drugs as some of them may have serious side effects. Alternative treatments, such as acupuncture may also provide relief, especially when used in conjunction with medications.
Depending on the type of neuropathy, the doctor will suggest the most suitable therapies, medications, or lifestyle changes that would help the patient to be able to cope with the symptoms and prevent possible complications. For example, if the patient has digestive problems as a complication of their neuropathy, a doctor may suggest limiting the amount of fat and fibre in the diet, as well as recommending eating smaller meals more often.
Diabetic neuropathy is a common condition in people suffering from diabetes and can lead to serious foot complications, which in some cases, may even lead to amputation. It is crucial to take special care of your feet if you have peripheral or diabetic neuropathy and seek medical help immediately if you have inflammation or injury.
Often, this condition can be avoided by controlling and managing blood glucose levels constantly. In order to keep the blood glucose within its normal levels, it is recommended to maintain an active lifestyle, manage a healthy diet, and take medications as prescribed. In addition to this, you should work closely with your doctor and follow their recommendations to slow the disease progression. With proper care and correctly chosen treatment, you can reduce the damage to nerves and avoid complications.
How effective is CBD in the treatment of neuropathic pain?
Today, more than 20 million Americans struggle with peripheral neuropathy - a condition, which is characterised by nerve damage to our peripheral nervous system. Since the peripheral nervous system works as a communication network that exists between our central nervous system and the rest of the body, any conditions disrupting its work are highly debilitating for individuals.
When neuropathy affects the motor nerves, the quality of life of the patients with this diagnosis is significantly reduced as they experience muscle weakness, painful cramps, and uncontrolled twitching. When this condition affects sensory nerves of the peripheral nervous system, it may result in reduced sense of touch, difficulty controlling pain, and increased pain to stimuli that wouldn’t normally cause pain. When neuropathy affects the autonomic nerves, symptoms may include blood pressure issues, excess sweating, and gastrointestinal distress.
There are different methods of neuropathy treatment, although many people are now considering cannabidiol (CBD), as a potential standalone or complementary treatment for this condition as it is effective, safe, and has high pain-relieving potential.
So, how does CBD affect neuropathy symptoms, and can it become a possible new treatment for patients with a peripheral or diabetic neuropathy diagnosis? Let’s check what the research says.
CBD is one of the cannabinoids found in the Cannabis sativa plant. This chemical has been linked to a wide variety of health benefits, the most reported and promising of which include:
- Fighting inflammation
- Managing and relieving pain
- Easing epileptic seizures
- Reducing drug withdrawal
- Lowering anxiety and depression
- Protecting against blood glucose issues (such as type-1 diabetes)
- Slowing the progression of Alzheimer’s disease
- Fighting symptoms of cancer or side effects of cancer treatments
These are only some of the potential health benefits provided by CBD. Research into its therapeutic effectiveness is ongoing, and some of the potential properties of this cannabinoid are still being studied. In contrast to tetrahydrocannabinol (THC), which is another famous compound of the cannabis plant, CBD doesn’t have psychoactive properties and will not create a high effect, which is commonly associated with marijuana.
All the health benefits provided by cannabidiol are due to its interaction with the receptors of our internal endocannabinoid system (ECS). This system is responsible for the regulation of our health and response to diseases. By interacting with CB1 and CB2 receptors of the ECS, cannabidiol helps to boost the immune system and create an anti-inflammatory response. In addition to this, when CBD is introduced into the ECS, it creates positive responses within the central and peripheral nervous systems, such as pain relief.
A range of studies has confirmed the analgesic properties of this compound for multiple types of pain, including neuropathic, cancer, and chronic pain. One of these studies held in 2018, highlighted the top three medical conditions for which people used CBD. Among them were:
Besides this, 36% of all respondents of this study reported that CBD was effective in easing their medical conditions, while only 4.3% of the study participants stated that it didn’t work effectively enough.
Another study investigating the use of cannabinoids in the management of difficult to treat pain demonstrated that these compounds may offer significant benefits. Moreover, authors of the study state that besides analgesia, cannabinoids may offer other beneficial side effects, such as antiemetic effects, neuroprotective antioxidant properties, improvements in symptomatic insomnia, and the ability of CBD and THC to produce apoptosis in malignant cells. Researchers also state that cannabinoid analgesics have been well-tolerated in clinical trials with very limited adverse effects, such as nausea, dry mouth, fatigue, and dizziness.
One of the main benefits of using CBD to reduce neuropathic pain is that this cannabinoid decreases the reliance on pain medication. Such an ability to substitute common medications with natural compounds is especially important as, in the US, about 130 people die every day from opioid overdose. OTC pain medications that are commonly prescribed for alleviation of neuropathic pain aren’t much better when it comes to the overall health of the patients.
According to one of the studies investigating the risks of chronic NSAIDs used in older adults, these medications may increase the risk of acute renal failure, peptic ulcer disease, and myocardial infarction occurrence. Also, this category of painkillers may interact with other prescription medications, such as corticosteroids and blood thinners. Substituting these drugs with CBD for neuropathic pain relief might help to avoid these serious side effects and reduce the risk of potentially dangerous complications.
Which type of CBD should I use?
Another question often asked regarding CBD use for neuropathic pain is which option to choose - CBD isolate, broad-, or full-spectrum CBD. Isolate is a CBD extract which contains only CBD in high concentration and can provide many health benefits. Broad-spectrum CBD contains most of the compounds from the cannabis plant but no traces of THC and full-spectrum CBD contains all of the compounds, including legal levels of THC. In the UK the legal level is 0.2% and in the US it is 0.3%.
According to the Ministry of Hemp, broad- and full-spectrum cannabidiol products can be more effective as they contain more cannabis plant compounds and, due to the entourage effect, wherein the compounds enhance one another, can offer users more health benefits. Research into the Cannabis sativa strain of the cannabis plant confirms this by explaining that such a positive effect can be provided by the synergy of all of the plant compounds together.
When taking full-spectrum CBD oil, it is important to evaluate the bioavailability of each method of delivery as some of the beneficial ingredients are metabolised during the digestive process and then only a small fraction of the administered product will reach the systemic circulation. In order to get the highest effectiveness of CBD oil for neuropathic pain, it’s best to take it sublingually. However, combining CBD oil with topical CBD lotion or cream can also be helpful in pain management as topical products enable direct application of CBD oil to the areas that hurt the most.
The bottom line
CBD has become a promising treatment option for a lot of conditions, including neuropathic pain caused by peripheral neuropathy or diabetic neuropathy. The analgesic properties of CBD have been confirmed in a range of studies and trials, although some questions remain open. The bioavailability of different methods of delivery, the most effective dosage of CBD products, and the advantages of broad- and full-spectrum CBD oil in comparison to CBD isolate are still being studied. Nevertheless, CBD may become an effective treatment option due to its anti-inflammatory and analgesic properties, along with the lack of serious side effects in comparison to opioids and other prescription medications. In addition to this, cannabidiol doesn’t affect cognition as it has no psychoactive capabilities.
Maybe it is too early to make final conclusions as research investigating CBD benefits for neuropathic pain is continuing, though initial studies indicate that CBD may be a great addition in the fight against neuropathic pain. Cannabidiol may not be a cure, but it appears to have great potential in helping people manage some of the symptoms of peripheral neuropathy, including neuropathy pain that affects their quality of life most of all.